Alterações nas curvas glicêmicas de pacientes com Diabetes Mellitus gestacional pelo critério IADPSG e a repercussão no peso fetal ao nascimento

Abstract

Gestational Diabetes Mellitus (GDM) is classified as glucose intolerance, whose onset or detection occurs during pregnancy. One of the ways to identify GDM is 75g oral glucose tolerance test. According to the International Diabetes and Pregnancy Association Study Group(IADPSG), GDM is diagnosed when at least 1 of the three curve points are greater than or equal to 92, 180 and 153 mg / dl at time 0 , 1 and 2 hours respectively. A characteristic of this criterion is the diagnosis based on a single altered value. However, the mechanisms involved in impaired fasting glucose (IFG) are different from those found in impaired glucose tolerance (IGT) after oral glucose tolerance test (OGTT). So, differences in pregnancy outcomes are possible according to OGTT behavior. This work had as general objective to categorize pregnant women diagnosed with GDM, using the IADPSG criteria, according to the type of glycemic alteration found in the OGTT results, and to correlate with fetal weight birth. In order to do so, the cases of DMG treated at the University Hospital of the Federal University of Maranhão, from December 2013 to December 2015, were divided into 3 groups, according to the alterations found in the glycemic curve of the OGTT (Group 1: IFG isolated, Group 2: IGT only, Group 3: IFG and IGT). A total of 89 patients were studied, the majority belonging to groups 3 (54%). This same group had the highest glycemic averages at diagnosis and during follow-up, being the group with the highest occurrence of newborns large for gestational age (LGA), with 39.6%. Then group 1 with an occurrence of 27.3% of newborns LGAs. It was concluded that, as pregnant women with DMG with altered fasting glycemia in the OGTT, especially those with associated glucose intolerance, presented a higher risk for newborns large for gestational age.